Enema

A procedure of evacuation or washing out of waste materials (feces or stool) from a person’s lower bowel

Enema administration involves instilling a solution into the rectum and colon

Types of Enema

Cleansing Enema

Given only when it has been ordered by the patient’s physician.

This is used most often to promote evacuation of the lower bowel when this does not happen naturally.

May be given in preparation for certain diagnostic tests. They are frequently used in preparing a patient for procedure or surgery.

Oil Retention Enema

The procedure for giving the retention enema is different from that for the cleansing enema. The patient is expected to retain (hold in) the enema solution for 10 – 20 minutes. Sometimes a supsoads (cleansing) enema is given 20 minutes after the oil

retention enema has been expelled.

Retention enemas are given to:

Helps soften the feces and gently stimulate evacuation

Lubricate the inside surface of the lower intestine

Soften the stool, if necessary

Ease the passage of feces without straining

Provide laxative benefits when oral laxatives are not allowed

Soften fecal impaction when straining might be harmful or painful

Harris Flush (Return – Flow Harris Flush (Return – Flow Enema)Enema)

An irrigation of the rectum (rectal An irrigation of the rectum (rectal irrigation). Irrigation means washing irrigation). Irrigation means washing out. Clean water runs into the out. Clean water runs into the rectum. Flatus (gas) & water run out rectum. Flatus (gas) & water run out of the rectum. Again, clean water of the rectum. Again, clean water runs into the rectum. Flatus & water runs into the rectum. Flatus & water run out of the rectum in the return run out of the rectum in the return flow. flow. The procedure is repeated for The procedure is repeated for 10 minutes until the patient is 10 minutes until the patient is relieved of excess gas.relieved of excess gas.

Barium Enema

A.Description

1. Fluoroscopic x – ray examination visualizing the entire large intestine is administered after the patient is given an enema of barium sulfate.

2. Can visualize structural changes, such as tumors, polyps, diverticula, fistulas, obstructions, and ulcerative colitis.

3. Air may be introduced after barium to provide a double contrast study.

B. Nursing/Patient Care Considerations

1.Explain to the patient:

a. What the x – ray procedure involves.

b. That proper preparation provides a more accurate view of the tract & that preparations may vary.

c. That it is important to retain the barium so that all surfaces of the tract are coated with opaque solution.

2. Instruct the patient on the objective of having the large intestine as clear of fecal material as possible:

a. The patient may be given a low residue diet 1 to 3 days

before the examination.

b. The day before the examination, intake may be limited to clear liquids.

c. The day before the examination, a cathartic may be prescribed.

d. The evening before & on the morning of the examination, a

cleansing enema may be given. Food & fluids are restricted before the examination.

3. Encourage the patient to eat after the examination, because he or she has been fasting & is undoubtedly hungry.

4. Prepare the patient for an enema or cathartic after the barium enema, and describe its

importance in evacuating the barium and preventing impaction.

5. Advise the patient that barium may cause light – colored stools for several days after the procedure.